| NPI | 1134679798 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETITIA JEAN GOLDEN Nurse Practitioner 304-623-3461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: WV 77023) |
| Enumeration Date | 2016-10-07 |
| Last Update Date | 2016-10-07 |